BILL ANALYSIS
AB 82
Page 1
Date of Hearing: March 24, 2009
ASSEMBLY COMMITTEE ON HUMAN SERVICES
Jim Beall, Jr., Chair
AB 82 (Evans) - As Introduced: December 23, 2008
SUBJECT : Dependent children: psychotropic medications.
SUMMARY : Changes the requirements that must be met before and
after a juvenile court judicial officer authorizes the
administration of psychotropic medications to foster children.
Specifically, this bill :
1)Authorizes juvenile court judicial officers to make orders
regarding the administration of psychotropic medications to a
child who has been removed from the physical custody of a
parent or guardian, pending adjudication as a dependent child.
2)Requires physicians or other health professionals requesting
authorization to administer psychotropic medications to a
dependent child, a child awaiting adjudication as a dependent
child, or a ward of the court in foster care to have conducted
an examination and to include information on the child's
medical history, the probability of side effects of the
medication, and a description of recommended therapy in the
request.
3)Requires the juvenile court judicial officer, before
authorizing the administration of psychotropic medication, to
make findings that:
a) The child's caregiver has been informed, and the child
has been informed in an age and developmentally appropriate
manner, about the recommended medications, anticipated
benefits, possible side effects and any other recommended
treatment;
b) The child has been informed of his or her right to
request a hearing on the issue; and
c) A plan is in place for the physician to monitor the
medication, in consultation with the child's caregiver,
mental health care provider, and others as appropriate.
4)Requires the Department of Mental Health to identify or
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develop written materials by July 1, 2010 to assist in the
provision of age-appropriate information about psychotropic
medications to minors.
5)Requires that a dependent child or ward in foster care be
present in court for a hearing on the request to administer
psychotropic medications, unless the child waives the right to
attend after consulting with counsel or the court finds good
cause for his or her absence.
6)Authorizes the court, in proceedings following orders
regarding administration of psychotropic medication to inquire
about:
a) The effectiveness and side effects of the medication,
the child's progress toward treatment goals, and any
changes recommended, as reported by the physician
b) Any behavior changes and possible side effects observed
by individuals in regular contact with the child, and
c) Any statements or concerns expressed by the child about
the medication.
7)Requires the Judicial Council to adopt rules and forms to
implement the above provisions by July 1, 2010.
8)Makes other technical, non-substantive changes.
EXISTING LAW :
1)Defines psychotropic medication or drugs as those medications
administered for the purpose of affecting the central nervous
system to treat psychiatric disorders or illnesses. Welfare
and Institutions Code (WIC) 369.5; 739.5.
2)Authorizes only a juvenile court judicial officer to make
orders about the administration of psychotropic medications to
a child who was removed from his or parent's custody and
declared a dependent of the court, unless the court issues a
specific order delegating that authority to a parent or
guardian after making specified findings. Id.
3)Requires that the juvenile court's authorization to administer
psychotropic medications be based on a physician's request
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which includes the reasons for the request, a description of
the child's diagnosis and behavior, the expected results of
the medication, and a description of any side effects of the
medication. Id.
4)Provides that judicial officers have 7 days to approve or deny
the request, or to set the matter for a hearing upon request
by the parent, legal guardian, or child's attorney. Id.
5)Defines prescribing, dispensing, or furnishing dangerous drugs
without an appropriate prior examination and a medical
indication as unprofessional medical conduct, except as
specified. Business and Professions Code 2242.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of the bill : The author summarizes the goal of this
bill as the creation of additional safeguards in the court
approval process for requests to administer psychotropic
medication to foster youth. According to the author,
psychotropic medications can be a key component of effective
treatment for conditions affecting some foster youth. However,
the author also notes that in 2006 testimony ". . . some youth
reported being put on medications when they were very young- as
young as 4 or 5 years old- and remaining on various medications
for their entire childhoods. Other youth described being
prescribed multiple medications at the same time. . . Youth
reported experiencing serious side effects- drowsiness, weight
gain, insomnia, drooling, facial tics, etc. - and receiving
little or no monitoring of the effectiveness of their
medications. . . Other foster youth on medication indicated
that they did not receive effective therapy and/or behavioral
interventions that could have reduced or eliminated the need for
medication. . ."
Additional background on the use of psychotropic medications :
There is little to no aggregated data on the scope of the use of
psychotropic medication for youth in the California foster care
system. While some studies and articles document experts'
concerns about inappropriate or over-medication of children in
foster care, others raise concerns about the potential for
under-medicating youth who might benefit from psychotropic
medications. In general, there is not consensus about the
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efficacy or appropriate level of usage of psychotropic
medications for children in the population at large or for
children in foster care.
Prior legislation : Existing provisions regarding juvenile court
authority to make orders about the administration of
psychotropic medications to foster children were added by SB 543
(Bowen), Chapter 552, Statutes of 1999, in response to concerns
about potential overuse of psychotropic medication for children
in foster care and the inappropriateness of allowing parents
whose children were removed to consent to the use of such
medications (unless the juvenile court specifically determined
that they should have such authority). The timeframe in which
the court must approve, deny or set a hearing about a request
was created by AB 2502 (Keene), Chapter 329, Statutes of 2004.
Parallel provisions regarding court authority to make orders
about the administration of psychotropic medications to a ward
of the court who is removed from the physical custody of a
parent and placed into foster care were added by AB 1514 (Maze),
Chapter 120, Statutes of 2007. According to the Assembly
analysis for Concurrence in Senate Amendments to AB 1514, the
Department of Social Services sponsored that bill to remedy
disparities between the way wards in foster care and dependents
in foster care may be prescribed psychotropic medications.
AB 2117 (Evans, 2008) contained provisions similar to the
provisions of AB 82. AB 2117 was held in the Senate
Appropriations Committee.
A few clarifications may be helpful : The author's office is
working with organizations representing medical professionals to
ascertain the best terminology with which to describe
professionals who are authorized to administer medications. The
author's office may also wish to consider clarifying the process
by which the judge may inquire about side effects, treatment and
the child's statements about medications (i.e. to specify who
will report on that information).
DOUBLE REFERRAL . This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to the
Assembly Judiciary Committee.
REGISTERED SUPPORT / OPPOSITION :
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Support
Children's Law Center (sponsor)
California Youth Connection
Family Law Section, State Bar of California
Junior Leagues of California State Public Affairs Committee
Sacramento Child Advocates
Western Center on Law & Poverty
Youth Law Center
Opposition
None on file
Analysis Prepared by : Jennifer Troia / HUM. S. / (916)
319-2089